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GSK- Ada investor-meeting-june-2012
1. ADA Analyst Presentation
Saturday 9th June
Carlo Russo
Senior Vice-President & Albiglutide Team Leader, GSK
Property of GlaxoSmithKline
2. Agenda
Welcome & introduction to the Carlo Russo
Harmony Clinical Programme Senior Vice-President, Albiglutide
Team Leader
Results from Harmony 6 & Harmony 7 Dr Richard E. Pratley
Director, Florida Hospital Diabetes
Institute, USA
The Evolution of Type 2 Diabetes Professor Philip Home
Treatment Professor of Diabetes Medicine,
Newcastle University, UK
Q&A discussion
Refreshments
3. The HARMONY Programme: Ongoing Phase III Studies
No. of Patients Primary Estimated
Study Background Therapy Comparators Randomized Endpoint LPLV
COMPLETED
H2H vs liraglutide Metformin, pioglitazone,
Liraglutide 841 32 weeks Presented at
HARMONY 7 glimepiride, or combination
ADA 2012
Add-on to COMPLETED
insulin glargine Basal insulin glargine Prandial insulin 586 6 months Presented at
HARMONY 6 ADA 2012
Renal impairment Metformin, pioglitazone,
Sitagliptin 507 6 months Jul 2012
HARMONY 8 glimepiride, or combination
Monotherapy Diet & exercise (treatment-
Placebo 309 1 year Jan 2013
HARMONY 2 naรฏve patients)
Add-on to
pioglitazone Pioglitazone ยฑ metformin Placebo 310 1 year Jan 2013
HARMONY 1
Add-on to
metformin + SU Metformin + glimepiride Pioglitazone or placebo 685 1 year Mar 2013
HARMONY 5
H2H vs
insulin glargine Metformin or
Insulin glargine 779 1 year Feb 2013
metformin + SU
HARMONY 4
Add-on to
metformin Sitagliptin, glimepiride,
Metformin 1049 2 years Feb 2013
HARMONY 3 or placebo
4. Harmony 6 Results
Add-on to Insulin Glargine vs prandial Lispro
Insulin in Subjects With Type 2 Diabetes
Mellitus
Richard Pratley MD
Director, Florida Hospital Diabetes Institute & Diabetes Professor,
Sanford Burnham Medical Research Institute, Florida, US
5. Harmony 6 Study Design Primary Endpoints:
โข Non-inferiority vs
Albiglutide 30 โ 50 mg weekly lispro
Insulin glargine โข Superiority vs
โฅ20 units per day n = 250 lispro, if non-
N = 500 Prandial lispro inferiority met
HbA1c: 7-10.5% Other Endpoints:
N = 250 โข Time to, and %
requiring rescue
โข Weight
โข Hypoglycemia
โข QoL
โข FP
Study Design
โข Randomized, open-label active controlled, parallel group study
โข Optional up-titration of albiglutide 30โ50 mg weekly, starting at Week 8
โข Titration of basal and pre-prandial insulin, to meet pre-specified protocol
criteria
โข Primary Endpoint: 26 weeks
โข Study Duration: 52 weeks
โข 586 randomized; 566 received treatment
6. Overall Conclusions
๏ง Efficacy
โ Both albiglutide and lispro produced clinically significant reductions
in HbA1c from baseline (-0.82 % vs -0.66%, respectively)
โ Albiglutide met the non-inferiority endpoint for HbA1c vs. lispro
(p<0.0001) at 26 weeks, and only just missed showing superiority
(p=0.0533)
โ The FPG trend mirrored the HbA1c curve, with greater reduction in
the albiglutide treatment arm than the pre-prandial Lispro arm
โ The observed weight change at Week 26 in the albiglutide arm was
statistically greater than the pre-prandial insulin arm (-0.73 kg vs
+0.81 kg)
โ No meaningful difference between treatment groups when viewed by
subgroup (background OAD, gender, race, etc)
โ Efficacy and weight loss in the albiglutide arm were maintained
through 52 weeks
7. Overall Conclusions
๏ง Safety
๏ง The 52 week nausea/vomiting rates for albiglutide were consistent with
Harmony 7. Rates were higher in the albiglutide arm compared to Lispro:
โ Nausea: 13.0% with albiglutide and 2.1% with Lispro
โ Vomiting: 7.0% with albiglutide and 1.4% with Lispro
โ Hypoglycemia at week 52: 32.6% with albiglutide and 49.8% with Lispro
โ Three events of severe hypoglycemia in the pre-prandial Lispro arm vs zero in the
albiglutide arm
๏ง Rates of events of special interest at Week 52 with albiglutide were
consistent between this study and Harmony 7:
โ Injection site reactions: 9.5% with albiglutide and 5.3% with Lispro
โ Acute pancreatitis: Zero events with both albiglutide and Lispro
โ Thyroid nodules/neoplasm: one subject who received one dose of albiglutide with calcitonin
elevated at baseline & subsequently determined to be MEN positive, and no subjects with Lispro
8. Harmony 7 Results
A Randomized, Open-Label, Parallel-Group,
Multicenter Study to Determine the Efficacy and
Safety of Albiglutide as Compared With Liraglutide in
Subjects With Type 2 Diabetes Mellitus
9. Harmony 7 Study Design
Primary endpoints
โข Noninferiority
Inadequate control Albiglutide (โฅ superiority) vs
on Met, TZD, SU, or n = 400 liraglutide
combination Other endpoints
N = 800 Liraglutide โข FPG
HbA1c: 7%-10% n = 400 โข Time to rescue
โข Weight
โข Hypoglycemia
โข QoL
Study Design
โข Randomized, double-blind, active-controlled, parallel-group study
โข Titration protocol of albiglutide 30 โ 50 mg QW and liraglutide
(1.2 โ 1.8 mg QD)
โข Study duration: 32 weeks
โข Primary endpoint: Change in HbA1c from baseline as compared
with liraglutide
10. Overall conclusions
๏ง Liraglutide (once daily) and albiglutide (once weekly) clinically and
statistically reduced HbA1c from baseline. (โ0.78% 0.99 with ALBI
and โ0.99% 1.02 with LIRA [treatment difference: 0.21% P < .001])
๏ง The treatment difference did not meet non-inferiority criteria. (95%
CI: 0.08โ0.34%).
๏ง Albiglutide was generally well tolerated and had a better GI
tolerability than liraglutide
๏ง Both agents showed reductions in weight loss, but this was better
with liraglutide (LIRA [โ2.19 kg] greater than ALBI [โ0.64 kg])
11. Type II diabetes:
An evolving treatment landscape
Professor Philip Home
Professor of Diabetes Medicine, Newcastle University, UK